[Pulmonary edema due to inhalation of gas and vapors]

In 1975, France will have manufactured 3.2 million tons of plastic materials which by pyrolysis, liberate chlorine, methyl chloride, hydrocyanic acid, hydrofluoric acid and other toxic gases. Now these materials are burnt in fires in "modern", buildings or vehicles , associated with fats (acrolein) and other gases and toxic industrial or household fumes which attack the lung. At sufficient dosage these agressive agents have first of all a "suffocating" action when in case of survival, a caustic and corrosive action. Pulmonary edema of the lesional type is met with at two stages in these cases. They are due to a direct action on the bronchial epithelium and an indirect action by disturbance of surfactant metabolism. It is an edema which is interstitial above all, and secondarily endo-alveolar. Study of the clinical, radiological, bronchoscopic and hemodynamic symptomatology. Differential diagnosis is not always easy. The possibility of burns of the respiratory pathways, blast, must be looked at. These elements can moreover be associated with lesions due to toxic inhalation. In case of survival the course is one of fibrosis with a restrictive syndrome.